Department of Pediatrics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China.
Department of Pediatrics, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China.
Chin Med J (Engl). 2019 Aug 20;132(16):1942-1950. doi: 10.1097/CM9.0000000000000380.
Henoch-Schonlein purpura nephritis (HSPN) is a very common secondary kidney disease of childhood. Its pathogenesis and the treatment mechanism of glucocorticoid have not been fully elucidated. The aim of this study was to determine the relationship between p300 and the pathogenesis, glucocorticoid therapy in mice with HSPN, respectively.
Forty-eight C57BL/6N male mice, weighing 18 to 20 g, were selected (3-4 weeks old, n = 8 per group). The mice in the normal control group (Group I) were given normal solvent and the HSPN model group (Group II) were given sensitizing drugs. The mice in Group III were injected intraperitoneally with dexamethasone after being given sensitizing drugs. Meanwhile, mice in Groups IV, V and VI with conditional knockout of p300 were also given normal solvent, sensitizing drugs and dexamethasone.The levels of serum IgA, creatinine, and circulating immune complex (CIC) concentrations, 24 h urinary protein and urinary erythrocyte in C57 wild mice, and p300 conditional knockout mice in each group were measured. The expression of p300 in renal tissues and the expression of glucocorticoid receptor (GR) α and β, transforming growth factor (TGF)-β1, and activator protein (AP)-1 after dexamethasone treatment were determined by real-time polymerase chain reaction and Western blotting.
Compared with the normal solvent control group (Group I), the expression of p300 mRNA in the model group (Group II) was significantly up-regulated. Western blotting further confirmed the result. Urinary erythrocyte count, 24 h urinary protein quantification, serum IgA, CIC, and renal pathologic score in Group V were distinctly decreased compared with non-knockout mice in Group II (9.7 ± 3.8 per high-power field [/HP] vs. 18.7 ± 6.2/HP, t = 1.828, P = 0.043; 0.18 ± 0.06 g/24 h vs. 0.36 ± 0.08 g/24 h, t = 1.837, P = 0.042; 18.78 ± 0.85 mg/mL vs. 38.46 ± 0.46 mg/mL, t = 1.925, P = 0.038; 0.80 ± 0.27 μg/mL vs. 1.64 ± 0.47 μg/mL, t = 1.892, P = 0.041; 7.0 ± 0.5 vs. 18.0 ± 0.5, t = 1.908, P = 0.039). Compared with non-knockout mice (Group III), the level of urinary erythrocyte count and serum IgA in knockout mice (Group VI) increased significantly after treatment with dexamethasone (3.7 ± 0.6/HP vs. 9.2 ± 3.5/HP, t = 2.186, P = 0.024; 12.38 ± 0.26 mg/mL vs. 27.85 ± 0.65 mg/mL, t = 1.852, P = 0.041). The expression level of GRα was considerably increased in the knockout group after dexamethasone treatment compared with non-knockout mice in mRNA and protein level (t = 2.085, P = 0.026; t = 1.928, P = 0.035), but there was no statistically significant difference in the expression level of GRβ between condition knockout and non-knockout mice (t = 0.059, P = 0.087; t = 0.038, P = 1.12). Furthermore, the expression levels of glucocorticoid resistance genes (AP-1 and TGF-β1) were notably increased after p300 knockout compared with non-knockout mice in mRNA and protein level (TGF-β1: t = 1.945, P = 0.034; t = 1.902, P = 0.039; AP-1: t = 1.914, P = 0.038; t = 1.802, P = 0.041).
p300 plays a crucial role in the pathogenesis of HSPN. p300 can down-regulate the expression of resistance genes (AP-1 and TGF-β1) by binding with GRα to prevent further renal injury and glucocorticoid resistance. Therefore, p300 is a promising new target in glucocorticoid therapy in HSPN.
过敏性紫癜肾炎(HSPN)是儿童常见的继发性肾脏疾病。其发病机制和糖皮质激素治疗机制尚未完全阐明。本研究旨在分别确定 p300 与 HSPN 发病机制和糖皮质激素治疗的关系。
选择 48 只 C57BL/6N 雄性小鼠,体重 18-20g(3-4 周龄,每组 8 只)。正常对照组(I 组)给予正常溶剂,HSPN 模型组(II 组)给予致敏药物。致敏后,III 组小鼠腹腔注射地塞米松。同时,IV、V 和 VI 组条件敲除 p300 的小鼠也给予正常溶剂、致敏药物和地塞米松。测量每组 C57 野生型小鼠和 p300 条件敲除小鼠的血清 IgA、肌酐和循环免疫复合物(CIC)浓度、24 小时尿蛋白和尿红细胞。用实时聚合酶链反应和 Western blot 法检测肾组织中 p300 的表达以及地塞米松处理后 GRα和β、转化生长因子(TGF)-β1和激活蛋白(AP)-1的表达。
与正常溶剂对照组(I 组)相比,模型组(II 组)p300mRNA 的表达明显上调。Western blot 进一步证实了这一结果。与非敲除组 II 组相比,V 组的尿红细胞计数、24 小时尿蛋白定量、血清 IgA、CIC 和肾病理评分明显降低(9.7±3.8/高倍视野[/HP]比 18.7±6.2/HP,t=1.828,P=0.043;0.18±0.06g/24h 比 0.36±0.08g/24h,t=1.837,P=0.042;18.78±0.85mg/mL 比 38.46±0.46mg/mL,t=1.925,P=0.038;0.80±0.27μg/mL 比 1.64±0.47μg/mL,t=1.892,P=0.041;7.0±0.5 比 18.0±0.5,t=1.908,P=0.039)。与非敲除组(III 组)相比,敲除组(VI 组)小鼠经地塞米松治疗后尿红细胞计数和血清 IgA 水平明显升高(3.7±0.6/HP 比 9.2±3.5/HP,t=2.186,P=0.024;12.38±0.26mg/mL 比 27.85±0.65mg/mL,t=1.852,P=0.041)。与非敲除组相比,敲除组在 mRNA 和蛋白水平上 GRα 的表达水平明显升高(t=2.085,P=0.026;t=1.928,P=0.035),但 GRβ 的表达水平在条件敲除和非敲除小鼠之间没有统计学差异(t=0.059,P=0.087;t=0.038,P=1.12)。此外,与非敲除组相比,p300 敲除后糖皮质激素抵抗基因(AP-1 和 TGF-β1)的表达水平在 mRNA 和蛋白水平上明显升高(TGF-β1:t=1.945,P=0.034;t=1.902,P=0.039;AP-1:t=1.914,P=0.038;t=1.802,P=0.041)。
p300 在 HSPN 的发病机制中起关键作用。p300 可以通过与 GRα 结合下调抵抗基因(AP-1 和 TGF-β1)的表达,防止进一步的肾损伤和糖皮质激素抵抗。因此,p300 是 HSPN 糖皮质激素治疗的一个有前途的新靶点。